Sasha Madrigal MSW
Sasha Madrigal MSW Registered Clinical Social Work Intern | License No. ISW22657 Under the supervision of Milagros Garcia, LCSW | License No. SW19836

If you're in crisis right now

If you're thinking about suicide, in danger of hurting yourself, or need immediate support, call or text 988 (988 Suicide & Crisis Lifeline) or chat at 988lifeline.org — free, confidential, available 24/7. If you're in immediate physical danger, call 911. This website and its contact form are not monitored for emergencies.

What high-functioning anxiety can look like

Anxiety isn't always visible from the outside. For many high achievers, it shows up as a mind that won't slow down, a body that stays tense even at rest, a habit of over-preparing or over-checking, difficulty delegating or resting, and a nagging sense that something is about to go wrong even when things are objectively fine. It can coexist with real success — which is part of what makes it easy to dismiss or push through instead of address.

Anxiety is one of the most common and most treatable mental health concerns. It's not a character flaw or a sign of weakness — it's a pattern the brain and body fall into, and patterns can shift with the right support and tools.

Try Today

A few research-backed techniques to try right now

These are widely used, evidence-informed tools drawn from cognitive behavioral therapy and clinical practice. They're not a replacement for treatment, but they can help take the edge off in the moment.

Box breathing (4-4-4-4)

  1. Breathe in slowly through your nose for a count of 4.
  2. Hold that breath for a count of 4.
  3. Exhale slowly through your mouth for a count of 4.
  4. Hold at the bottom for a count of 4, then repeat for 4–6 rounds.

Slow, controlled breathing activates the parasympathetic nervous system — the body's built-in "brake" — which can lower heart rate and ease the physical sensations of anxiety within a few minutes.

The 5-4-3-2-1 grounding technique

  1. Name 5 things you can see around you.
  2. Name 4 things you can physically feel or touch.
  3. Name 3 things you can hear.
  4. Name 2 things you can smell.
  5. Name 1 thing you can taste.

This technique uses your five senses to pull attention out of anxious or racing thoughts and back into the present moment — commonly used in trauma-informed and anxiety treatment.

Progressive muscle relaxation

  1. Starting at your feet, tense the muscles tightly for 5 seconds.
  2. Release the tension all at once and notice the difference.
  3. Move upward — calves, thighs, stomach, hands, arms, shoulders, face — repeating the tense-and-release for each muscle group.

Developed by physician Edmund Jacobson, this method helps the body recognize the physical difference between tension and relaxation, which can reduce the overall stress response over time.

The physiological sigh

  1. Take one long inhale through your nose.
  2. At the top, take a second short, sharp inhale to fully fill the lungs.
  3. Exhale slowly and fully through your mouth.
  4. Repeat 1–3 times.

This double-inhale pattern is one of the fastest ways studied to reduce physiological arousal in real time — useful right before something high-pressure, like a meeting or a difficult conversation.

National Resources

Free, national resources you can use anytime

These organizations are independent of this practice and offer free information, peer support, or crisis response nationwide. None of them require insurance.

988 Suicide & Crisis Lifeline

24/7 free, confidential support for suicidal crisis or emotional distress. Call, text, or chat.

Call/Text 988 · 988lifeline.org

SAMHSA National Helpline

Free, confidential, 24/7 treatment referral and information service for mental health and substance use.

1-800-662-4357 · samhsa.gov

Crisis Text Line

Free, 24/7 crisis support over text, from anywhere in the U.S.

Text HOME to 741741 · crisistextline.org

NAMI HelpLine

National Alliance on Mental Illness — free peer support, information, and referrals (not a crisis line).

1-800-950-6264 · nami.org

Anxiety & Depression Association of America (ADAA)

Research-backed information on anxiety disorders, self-help tools, and a therapist directory.

National Institute of Mental Health (NIMH)

The federal government's lead research agency on mental health — plain-language guides on anxiety and treatment options.

Mental Health America

Free, anonymous online screening tools and educational resources on anxiety and other conditions.

Not sure if therapy is the right next step?

That's exactly what a free 15-minute consultation is for — no pressure, just a conversation about what you're carrying and whether working together makes sense.